Biomarcadores de estrés oxidativo en la enfermedad de Huntington y otros desórdenes neurológicos: estudio comparativo

Fundamento: los biomarcadores de estrés oxidativo en la enfermedad de Huntington pudieran predecir el curso de la enfermedad y evaluar nuevos tratamientos, pero su naturaleza inespecífica parece impedir la identificación de algún marcador útil. Esclarecer similitudes y diferencias de este fenómeno y su comportamiento con características clínicas puede ser esencial. Objetivo comparar biomarcadores de estrés oxidativo entre pacientes con enfermedad de Huntington y con otros desórdenes neurológicos. Métodos se realizó un estudio analítico, retrospectivo y caso-control (enfermedad de Huntington esclerosis lateral amiotrófica, ataxia espinocerebelosa tipo 2 e ictus isquémico: en etapa aguda y crónica). Se recogieron variables demográficas, clínicas y marcadores de daño oxidativo (malonildialdehído, productos avanzados de oxidación a proteínas) y antioxidantes (superóxido dismutasa: catalasa: glutatión peroxidasa, capacidad antioxidante del plasma). Resultados hubo diferencias significativas del malonildialdehído en la enfermedad de Huntington respecto al control (p=0,02), pero no con el resto de los grupos. La enzima superóxido dismutasa en enfermedad de Huntington fue menor estadísticamente en comparación con esclerosis lateral amiotrófica, aunque para la catalasa fue superior en relación con el resto de los pacientes. El FRAP en enfermedad de Huntington resultó menor significativamente versus esclerosis lateral amiotrófica e ictus isquémico agudo. Los productos avanzados de la oxidación de proteína se correlacionaron directamente con las edades biológicas y de inicio de la enfermedad de Huntington. La actividad motora en la esclerosis lateral amiotrófica y el déficit neurológico en el ictus isquémico agudo se correlacionaron con el malonildialdehído y glutatión peroxidasa respectivamente. Conclusiones la enfermedad de Huntington parece mostrar características específicas en su sistema antioxidante. La oxidación de proteínas pudiera estar relacionada con la acumulación de huntingtina mutada en el tiempo.

Foundation: biomarkers of oxidative stress in Huntington's disease could predict the course of the disease and evaluate new treatments, but their nonspecific nature seems to prevent the identification of any useful marker. Clarifying similarities and differences of this phenomenon and its behavior with clinical characteristics may be essential. Objective: compare biomarkers of oxidative stress between patients with Huntington's disease and other neurological disorders. Methods: an analytical, retrospective and case-control study was carried out (Huntington's disease, amyotrophic lateral sclerosis, spinocerebellar ataxia type 2 and ischemic stroke: acute and chronic stage). Demographic and clinical variables and markers of oxidative damage (malonildialdehyde, advanced protein oxidation products) and antioxidants (superoxide dismutase: catalase: glutathione peroxidase, plasma antioxidant capacity) were collected. Results: there were significant differences in malonyldialdehyde in Huntington's disease compared to the control (p=0.02), but not with the rest of the groups. The enzyme superoxide dismutase in Huntington's disease was statistically lower compared to amyotrophic lateral sclerosis, although for catalase it was higher in relation to the rest of the patients. FRAP in Huntington's disease was significantly lower versus amyotrophic lateral sclerosis and acute ischemic stroke. Advanced products of protein oxidation were directly correlated with the biological and onset ages of Huntington's disease. Motor activity in amyotrophic lateral sclerosis and neurological deficit in acute ischemic stroke were correlated with malonyldialdehyde and glutathione peroxidase, respectively. Conclusions: huntington's disease seems to show specific characteristics in its antioxidant system. Protein oxidation could be related to the accumulation of mutated huntingtin over time.

Asociación de marcadores inflamatorios y de disfunción endotelial con la depresión en la enfermedad cerebrovascular isquémica

Fundamento: la depresión es una de las complicaciones no neurológicas más frecuentes en la enfermedad cerebrovascular isquémica. Objetivo: determinar la asociación de marcadores inflamatorios y de disfunción endotelial con la depresión en pacientes con enfermedad cerebrovascular isquémica. Métodos: se realizó un estudio analítico, prospectivo de corte transversal en pacientes con enfermedad cerebrovascular isquémica en fase aguda (N=22) y no aguda (N=37); atendidos en el Instituto de Neurología y Neurocirugía y el Hospital Manuel Fajardo, de La Habana, Cuba. Se recogieron variables demográficas, factores de riesgo, etiología y localización del infarto, deficiencia neurológica, discapacidad para las actividades de la vida diaria (índice de Barthel), neuropsicológicas (depresión por inventario de Beck y test de Hamilton). Se determinó proteína C-reactiva, alfa-1-antitripsina, complementos C3 y C4 y microalbuminuria. Resultados: las puntuaciones de las pruebas neuropsicológicas no tuvieron diferencias significativas entre la fase aguda y no aguda, pero hubo un aumento estadístico de la frecuencia de pacientes sin depresión y con ligera depresión en la fase no aguda. En la fase aguda, el complemento C4 y en la fase no aguda el complemento C3, la proteína C-reactiva y el alfa-1-antitripsina se correlacionaron directamente con la puntuación del inventario de Beck. La proteína C-reactiva y C3 se correlacionaron estadísticamente con la puntuación del test de Hamilton. En el análisis multivariado, la proteína C-reactiva mostró asociación independiente con el grado de depresión por el test de Hamilton. Conclusiones: la proteína C-reactiva pudiera estar relacionada con la severidad de la depresión, quizás por asociación con la discapacidad para las actividades de vida diaria.

Foundation: depression in ischemic cerebrovascular disease is one of the most frequent non-neurological complications. Objective: to determine the association of inflammatory markers and endothelial dysfunction with depression in patients with ischemic cerebrovascular disease. Methods: an analytical, prospective, cross-sectional study was carried out in patients with acute (N=22) and non-acute (N=37) ischemic cerebrovascular disease; treated at the Institute of Neurology and Neurosurgery; and the Manuel Fajardo Hospital, in Havana, Cuba. Demographic variables, risk factors, etiology and location of the infarction, neurological deficiency, disability for activities of daily living (Barthel index), neuropsychological (depression by Beck inventory and Hamilton test) were collected. C-reactive protein, alpha-1-antitrypsin, C3 and C4 complements, and microalbuminuria were determined. Results: the scores of the neuropsychological tests did not have significant differences between the acute and non-acute phase, but there was a statistical increase in the frequency of patients without depression and with slight depression in the non-acute phase. In the acute phase, C4, and in the non-acute phase, C3, C-reactive protein and alpha-1-antitrypsin were directly correlated with the Beck inventory score. C-reactive protein and C3 were statistically correlated with the Hamilton test score. In the multivariate analysis, C-reactive protein showed an independent association with the degree of depression by the Hamilton test. Conclusions: C-reactive protein could be related to the severity of depression, perhaps by association with the disability for activities of daily living.

You and me versus the rest of the world: the effects of affiliative motivation and ingroup partner status on social tuning.

Bandura argues that individuals are more likely to engage in social learning when they identify with a social model and when they are motivated or rewarded. Therefore, in the present work, we investigate how these two key factors, perceived similarity and affiliative motivation, influence the extent to which individuals engage in social tuning or align their views with an interaction partner-especially if their partner's attitudes differ from the larger social group. Experiment 1 (170 participants) explored the role of perceived similarity through group membership when needing to work collaboratively with a collaboration partner whose climate change beliefs differed from a larger social group. Experiment 2 (115 participants) directly manipulated affiliative motivation (i.e., length of interaction time) along with perceived similarity (i.e., Greek Life membership) to explore if these factors influenced social tuning of drinking attitudes and behaviors. Experiments 3 (69 participants) and 4 (93 participants) replicated Experiment 2 and examined whether tuning occurred for explicit and implicit attitudes towards weight (negative views Experiment 3 and positive views Experiment 4). Results indicate that when individuals experience high affiliative motivation, they are more likely to engage in social tuning of explicit and implicit attitudes when their interaction partner belongs to their ingroup rather than their outgroup. These findings are consistent with the tenets of Social Learning Theory, Shared Reality Theory, and the affiliative social tuning hypothesis.

The Gal/GalNac lectin as a possible acetylcholine receptor in Entamoeba histolytica.

Entamoeba histolytica (E. histolytica) is a protozoan responsible for intestinal amebiasis in at least 500 million people per year, although only 10% of those infected show severe symptoms. It is known that E. histolytica captures molecules released during the host immune response through membrane receptors that favor its pathogenetic mechanisms for the establishment of amebic invasion. It has been suggested that E. histolytica interacts with acetylcholine (ACh) through its membrane. This promotes the increase of virulence factors and diverse mechanisms carried out by the amoeba to produce damage. The aim of this study is to identify a membrane receptor in E. histolytica trophozoites for ACh. Methods included identification by colocalization for the ACh and Gal/GalNAc lectin binding site by immunofluorescence, western blot, bioinformatic analysis, and quantification of the relative expression of Ras 5 and Rab 7 GTPases by RT-qPCR. Results show that the Gal/GalNAc lectin acts as a possible binding site for ACh and this binding may occur through the 150 kDa intermediate subunit. At the same time, this interaction activates the GTPases, Ras, and Rab, which are involved in the proliferation, and reorganization of the amoebic cytoskeleton and vesicular trafficking. In conclusion, ACh is captured by the parasite, and the interaction promotes the activation of signaling pathways involved in pathogenicity mechanisms, contributing to disease and the establishment of invasive amebiasis.

Asymptomatic cerebral small vessel disease in adults with low cardiovascular risk.

Introduction: Cerebral small vessel disease (CSVD) frequently occurs in individuals with vascular risk factors. This condition might go unrecognised or result in only mild functional deficits. Objective: To evaluate the relationship between cardiovascular (CV) risk calculated with the HEARTS app and CSVD burden in a population without cardio-cerebrovascular diseases, and to estimate the prevalence of CSVD in low risk (LR) individuals. Methods: Asymptomatic subjects with vascular risk factors were included from primary health areas in Havana. The WHO's revised CV disease risk prediction chart (HEARTS app) was applied to all individuals, who were classified into two groups: LR and moderate/high risk (M/HR). Brain MRI was performed in all subjects. Results: 170 patients were included: 43 (25.3%) classified as low CV risk and 127 (74.7%) had M/HR CV risk. Half of the neurologically healthy individuals included displayed cerebral small vessel involvement (51.2%). White matter hyperintensities (WMH) and enlarged perivascular spaces were the most frequent lesions observed in both groups. WMH were more severe and more severe global score for CSVD were more frequent in the M/HR group (57.5%). It was noteworthy that 32.6% of LR-patients also exhibited more severe CSVD. The multivariate regression analysis revealed an independent association of arterial hypertension and age with the severity of CSVD. Conclusions: CV risk stratification through the HEARTS app has limited utility for predicting brain health in individuals with low CV risk. Identifying silent CSVD in individuals with apparently low CV risk is important, especially if they suffer from arterial hypertension.

Distraction in the Emergency department using Virtual reality for INtravenous procedures in Children to Improve comfort (DEVINCI): a pilot pragmatic randomized controlled trial.

OBJECTIVES: Intravenous (IV) procedures cause pain and distress in the pediatric emergency department (ED). We studied the feasibility and acceptability of virtual reality distraction for patient comfort during intravenous procedures. METHODS: Children were randomized to a control (standard care) or intervention group (standard care + virtual reality). Thresholds for feasibility and acceptability (primary outcomes) were determined through a priori established criteria. The level of procedural pain (principal clinical outcome) and distress, as well as memory of pain at 24 h were collected and reported as medians (Q1, Q3) for each group. RESULTS: 63 patients were enrolled, with a high rate of recruitment (78.8%) and game completion (90.3%). Patients, parents and, healthcare providers reported high satisfaction levels. There were no serious adverse events. Five of the 30 patients (16.7%) exposed to virtual reality reported mild side effects. Self-reported procedural pain (verbal numerical rating scale: 3 (1, 6)/10 vs 3 (1, 5.5)/10, p = 0.75) was similar between groups. Further exploratory clinical measures were reported for the intervention and control groups, respectively: self-rated distress during the procedure (Child Fear Scale: 1 (0, 2)/4 vs 2 (0, 3)/4); distress evaluated by proxy during the procedure (Procedure Behavior Check List: 8 (8, 9)/40 vs 10 (8, 15)/40); memory of pain at 24 h (VNRS: 2 (1, 3)/10 vs 4 (2, 6.5)/10). CONCLUSION: The addition of virtual reality to standard care is feasible and acceptable for pain and distress management during IV procedures in the pediatric ED. Occasional mild, self-resolving side effects were observed in the intervention group. Self-reported pain during the procedure was similar between groups. CLINICALTRIALS. GOV IDENTIFIER: NCT03750578.

RéSUMé: OBJECTIFS: Les procédures intraveineuses (IV) causent de la douleur et de la détresse dans le service des urgences pédiatriques (ED). Nous avons étudié la faisabilité et l'acceptabilité de la distraction en réalité virtuelle pour le confort du patient lors des procédures intraveineuses. LES MéTHODES: Les enfants ont été randomisés dans un groupe de contrôle (soins standard) ou d'intervention (soins standard + réalité virtuelle). Les seuils de faisabilité et d'acceptabilité (résultats primaires) ont été déterminés au moyen de critères établis a priori. Le niveau de douleur procédurale (résultat clinique principal) et de détresse, ainsi que la mémoire de la douleur à 24 heures ont été recueillis et rapportés sous forme de médiane (Q1, Q3) pour chaque groupe. RéSULTATS: 63 patients ont été inscrits, avec un taux élevé de recrutement (78,8 %) et de complétion du jeu (90,3 %). Les patients, les parents et les prestataires de soins de santé ont déclaré des niveaux de satisfaction élevés. Il n'y a pas eu d'événements indésirables graves. Cinq des 30 patients (16,7 %) exposés à la réalité virtuelle ont signalé des effets secondaires légers. La douleur procédurale auto-déclarée (échelle d'évaluation numérique verbale : 3 (1, 6)/10 vs 3 (1, 5,5)/10, p = 0,75) était similaire entre les groupes. D'autres mesures cliniques exploratoires ont été signalées respectivement pour les groupes d'intervention et de contrôle : détresse auto-évaluée pendant la procédure (échelle de peur de l'enfant: 1 (0,2) / 4 vs 2 (0, 3) / 4); détresse évaluée par procuration au cours de la procédure (Procedure Behavior Check List: 8 (8, 9)/40 vs 10 (8, 15)/40) ; mémoire de la douleur à 24 heures (VNRS : 2 (1, 3)/10 vs 4 (2, 6,5)/10). CONCLUSION: L'ajout de la réalité virtuelle aux soins standard est faisable et acceptable pour la gestion de la douleur et de la détresse pendant les procédures IV dans l'urgence pédiatrique. Des effets secondaires occasionnels légers et auto-régulants ont été observés dans le groupe d'intervention. La douleur auto-déclarée pendant l'intervention était similaire entre les groupes.

When mycologists describe new species, not all relevant information is provided (clearly enough).

Taxonomic mycology struggles with what seems to be a perpetual shortage of resources. Logically, fungal taxonomists should therefore leverage every opportunity to highlight and visualize the importance of taxonomic work, the usefulness of taxonomic data far beyond taxonomy, and the integrative and collaborative nature of modern taxonomy at large. Is mycology really doing that, though? In this study, we went through ten years' worth (2009-2018) of species descriptions of extant fungal taxa - 1,097 studies describing at most ten new species - in five major mycological journals plus one plant journal. We estimated the frequency at which a range of key words, illustrations, and concepts related to ecology, geography, taxonomy, molecular data, and data availability were provided with the descriptions. We also considered a range of science-demographical aspects such as gender bias and the rejuvenation of taxonomy and taxonomists as well as public availability of the results. Our results show that the target audience of fungal species descriptions appears to be other fungal taxonomists, because many aspects of the new species were presented only implicitly, if at all. Although many of the parameters we estimated show a gradual, and in some cases marked, change for the better over time, they still paint a somewhat bleak picture of mycological taxonomy as a male-dominated field where the wants and needs of an extended target audience are often not understood or even considered. This study hopes to leave a mark on the way fungal species are described by putting the focus on ways in which fungal taxonomy can better anticipate the end users of species descriptions - be they mycologists, other researchers, the public at large, or even algorithms. In the end, fungal taxonomy, too, is likely to benefit from such measures.

Increased C-reactive protein in acute ischemic stroke patients is age dependent / El incremento de la proteína C reactiva en pacientes con ictus isquémico agudo varía con la edad

Introduction: Several studies investigating blood biomarkers such as C-reactive protein (CRP) in the prognosis and mortality of stroke have not been conclusive. This may be related to the fact that age has not been taken into account for these analyses. Objective: In the present study, we evaluated the possible relationship of blood markers with the age and clinical characteristics of ischemic stroke patients. Methods: Two groups of acute ischemic stroke patients (≤ 55 years and > 55 years of age) who were paired with a control group were included. CRP, alpha 1 antitrypsin (AAT), complements C3 and C4, microalbuminura, ceruloplasmin, glucose, cholesterol, triglycerides, glutamic-piruvic transaminase (GPT), glutamic-oxalacetic transaminase (GOT), gamma glutamiltranspeptidase (GGT), creatinine, and uric acid were determined. Other clinical information, including NIH stroke scale was collected. Results: AAT, ceruloplasmin, microalbuminuria, GPT, GOT and GGT were significantly increased with respect to control subjects in both age groups. Nevertheless, CRP was increased only in patients older than 55 years. CRP and age were directly correlated in stroke patients, but not in the control group joint analysis of age and NIHSS revealed a tendency towards even higher CRP values in older patients with more severe neurological impairment. Levels of CRP increased significantly with age according to NIH score. Conclusions: Age should be considered when evaluating the usefulness of CRP and other blood biomarkers as clinical tools for predicting long or short-term neurological outcome or stroke recurrence events in ischemic stroke patients(AU)

Introducción: Los estudios sobre marcadores sanguíneos incluido la proteína C reactiva (PCR) en el pronóstico y mortalidad del ictus no han sido concluyentes, quizás porque en sus análisis no se ha tenido en cuenta la edad los pacientes. Objetivo: Evaluar la relación de los marcadores sanguíneos con la edad y características clínicas de pacientes con ictus isquémico. Métodos: Se incluyeron en el estudio 2 grupos de pacientes con ictus isquémico (( y > 55 años) quienes fueron pareados con grupos controles. Fueron determinados: PCR, alfa 1 antitripsina (AAT), complementos C3 y C4, microalbuminuria, ceruloplasmina, glucosa, colesterol, triglicéridos, transaminasa glutámico-pirúvico (TGP), transaminasa glutámico-oxalacético (TGO), gamma glutamiltranspeptidasa (GGT), creatinina, y ácido úrico. También, se recogió información clínica (escala neurológica, etiología y localización del ictus). Resultados: La AAT, ceruloplasmina, microalbuminuria, TGP, TGO y GGT aumentaron significativamente respecto al grupo control de ambos grupos de estudio. Sin embargo, la PCR se incrementó solamente en pacientes mayores de 55 años. La PCR se correlacionó directamente con la edad de los pacientes, pero no en el grupo control. A su vez, se observó una tendencia hacia el aumento de la PCR en pacientes mayores de 55 años con mayor la severidad neurológica. Los valores de PCR se incrementaron estadísticamente con la edad de acuerdo al déficit neurológico. Conclusiones: La edad debiera ser considerada en la evaluación de la utilidad de la PCR y de otros marcadores como herramientas clínicas para predecir un desenlace neurológico fatal o recurrencia de nuevos eventos en pacientes con ictus isquémico(AU)

CSF oligoclonal band frequency in a Cuban cohort of patients with multiple sclerosis. comparison with Latin American countries and association with latitude.

BACKGROUND: The diagnostic sensitivity of CSF specific oligoclonal bands (OCBs) in multiple sclerosis (MS), using state of the art methods, has been clearly established to be over 95% in patients with a predominantly Caucasian background. This is not the case for other geographical regions, where reports of OCB prevalence can be much lower, and a relationship between OCB frequency and latitude has been suggested. OBJECTIVE: The aim of the present study was to assess the frequency of OCBs in a cohort of MS patients evaluated at the Institute of Neurology and Neurosurgery (Havana, Cuba), and to review the scientific literature in order to investigate the possible relationship between OCB status and latitude in the region of Latin America. METHODS: Fifty-three patients (47 with definite MS and 6 with clinically isolated syndrome - CIS) were included. Isoelectric focusing (IEF) with IgG immunoblotting for OCB analyses, was performed placing paired CSF and serum samples in the same analytical run. PubMed, Scielo and Google Scholar were searched for papers containing information concerning CSF OCB status (employing isoelectric focusing with IgG immunoblotting) in patients with definite MS in Latin America and the Caribbean. RESULTS: In Cuban patients with definite MS, an OCB prevalence of 87% was observed, while the frequency in CIS patients was lower (67%). The prevailing pattern was that of OCBs restricted to the CSF (type 2), which was observed in 71% of definite MS patients and in all CIS patients with intrathecal IgG synthesis. OCB prevalence was slightly lower, but very close to that reported in Caucasian populations. Comparison with other Latin American countries revealed a significant correlation between OCB prevalence and latitude. CONCLUSIONS: A prevalence of CSF restricted OCBs of 87% was observed in definite MS patients, a frequency which was slightly lower, but similar to that reported in Caucasian populations. The analysis of OCB frequency in Latin American countries revealed a possible relationship between OCB prevalence and latitude, but this must be further investigated in more countries and larger samples of patients.

Cerebral Small Vessel Disease Associated with Subclinical Vascular Damage Indicators in Asymptomatic Hypertensive Patients.

Background: Cerebral small vessel disease (CSVD) is frequent in patients with cardiovascular risk factors including arterial hypertension, and it is associated with vascular damage in other organs and the risk of stroke, cognitive impairment, and dementia. Early diagnosis of CSVD could prevent deleterious consequences. Objective: To characterize CSVD associated with indicators of subclinical vascular damage in asymptomatic hypertensive patients. Materials and Methods: Participants were hypertensive (HT) and non-hypertensive (non-HT) individuals; without signs of cerebrovascular disease, dementia, and chronic renal failure. For CSVD, white matter hyperintensities (WMH), enlarged Virchow-Robin perivascular spaces (EVRPS), lacunar infarcts, and microbleeds were investigated. Subclinical vascular damage was evaluated (hypertensive retinopathy, microalbuminuria, and extracranial carotid morphology: intima media thickness (IMT) and atheroma plaque). Results: CSVD MRI findings were more frequent in HT; as well as greater intimal thickening. The IMT + plaque was significantly associated with all MRI variables; but retinopathy was correlated with EVRPS and lacunar infarcts. Only microalbuminuria was related to the greater severity of WMH in HT. Multivariate analysis evidenced that CSVD was independently associated with the combination of indicators of vascular damage and systolic blood pressure. Conclusions: Combining indicators of subclinical vascular damage, such as carotid morphological variables, microalbuminuria, and hypertensive retinopathy for early detection of CSVD in asymptomatic hypertensive patients could prove to be useful to take actions for the prevention of irreversible brain damage, which could lead to cognitive impairment, dementia and stroke.

Dietary patterns, central obesity and serum lipids concentration in Mexican adults.

INTRODUCTION: Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identified: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifiable risk factors.

INTRODUCCIÓN: Introducción: los patrones de dieta (PD) analizan la relación entre el consumo de alimentos o nutrimentos con la salud y el desarrollo de enfermedades en poblaciones. La elevada prevalencia de obesidad en adultos mexicanos se asocia con factores como el elevado consumo de ciertos grupos de alimentos y nutrimentos. Sin embargo, pocos estudios han explorado la asociación entre los patrones dietéticos y la obesidad en adultos aparentemente sanos. Objetivo: identificar los patrones dietéticos (PD) asociados con la obesidad central (OC) y las concentraciones séricas de lípidos en adultos. Métodos: estudio longitudinal del consumo dietético obtenido de múltiples recordatorios de consumo de 24 horas. La circunferencia de cintura (CC) y las mediciones bioquímicas se obtuvieron mediante procedimientos estandarizados; los PD, por análisis del componente principal. Mediante regresión logística se identificaron las asociaciones entre PD, OC y las concentraciones séricas de lípidos. Resultados: se identificaron tres PD: PD saludable, PD de riesgo y PD vacío. Los participantes del PD saludable presentaron menor riesgo de OC de acuerdo con los criterios de la CC (OR = 0.31, CI = 0.12, 0.82), p = 0.017, pero también fueron los que presentaron mayor riesgo de cifras elevadas de colesterol-LDL (OR = 2.98. CI = 1.16, 7.66), p = 0.030. No hubo asociación estadísticamente significativa entre el PD de riesgo y el PD vacío con obesidad o sobrepeso por IMC, OC por CC o con la presencia de dislipidemias. Conclusiones: el PD saludable se asocia con un menor riesgo para OC pero con mayor riesgo de elevación del colesterol-LDL. Se necesitan estudios longitudinales para esclarecer estas asociaciones para promover la reducción de factores de riesgo modificables.

Dietary patterns, central obesity and serum lipids concentration in Mexican adults / Patrones de dieta, obesidad central y concentración de lípidos séricos en adultos mexicanos

Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identifi ed: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifi able risk factors

Introducción: los patrones de dieta (PD) analizan la relación entre el consumo de alimentos o nutrimentos con la salud y el desarrollo de enfermedades en poblaciones. La elevada prevalencia de obesidad en adultos mexicanos se asocia con factores como el elevado consumo de ciertos grupos de alimentos y nutrimentos. Sin embargo, pocos estudios han explorado la asociación entre los patrones dietéticos y la obesidad en adultos aparentemente sanos. Objetivo: identificar los patrones dietéticos (PD) asociados con la obesidad central (OC) y las concentraciones séricas de lípidos en adultos. Métodos: estudio longitudinal del consumo dietético obtenido de múltiples recordatorios de consumo de 24 horas. La circunferencia de cintura (CC) y las mediciones bioquímicas se obtuvieron mediante procedimientos estandarizados; los PD, por análisis del componente principal. Mediante regresión logística se identificaron las asociaciones entre PD, OC y las concentraciones séricas de lípidos. Resultados: se identificaron tres PD: PD saludable, PD de riesgo y PD vacío. Los participantes del PD saludable presentaron menor riesgo de OC de acuerdo con los criterios de la CC (OR = 0.31, CI = 0.12, 0.82), p = 0.017, pero también fueron los que presentaron mayor riesgo de cifras elevadas de colesterol-LDL (OR = 2.98. CI = 1.16, 7.66), p = 0.030. No hubo asociación estadísticamente signifi cativa entre el PD de riesgo y el PD vacío con obesidad o sobrepeso por IMC, OC por CC o con la presencia de dislipidemias. Conclusiones: el PD saludable se asocia con un menor riesgo para OC pero con mayor riesgo de elevación del colesterol-LDL. Se necesitan estudios longitudinales para esclarecer estas asociaciones para promover la reducción de factores de riesgo modificables

Accumulation of current-use pesticides, cholinesterase inhibition and reduced body condition in juvenile one-sided livebearer fish (Jenynsia multidentata) from the agricultural Pampa region of Argentina.

The aim of this study was to characterize the level and nature of the pesticide contamination received by one-sided livebearer fish (Jenynsia multidentata) from a watercourse situated within the main agricultural region of Argentina, and to assess the effects of this contamination on fish health. Juvenile one-sided livebearer fish (Jenynsia multidentata) were collected in December 2011 and March 2012 from three sites along the Pergamino River. Pesticide contamination was characterized by extracting whole fish and analytically determining thirty different pesticide molecules. The biomarkers catalase, glutathione-S-transferase, and cholinesterases were assessed. Body condition was calculated as an estimate of the amount of energy reserves possessed by the fish. Seventeen different pesticides were detected in fish tissues with 81% of captured animals containing at least one pesticide molecule. The pyrethroid insecticides fenvalerate and bifenthrin were most frequently detected, being respectively found in 41.8 and 36.4% of samples tested. Highly toxic dichlorvos and pirimiphos-methyl were detected. Differential levels of contamination could not be established amongst sites but were observed within sites amongst the two sampling dates. The months when pesticide residues were most abundant from in Site A and B corresponded to the months when body condition was at its lowest in the two sites. The inhibition of Che activity in March when body condition was reduced also points to a role of insecticide contamination in the reduction of body condition. These findings provide strong new evidence that current-used agricultural pesticides can accumulate in wild fish and impact their health and energetics.

Association Between Dehydration and Fever During the First Week of Life.

BACKGROUND: Trying to differentiate serious bacterial infection (SBI) from a self-limiting illness in febrile infants seen in the pediatric emergency department (PED) is a significant challenge. The aim of the study was to determine the prevalence of dehydration and its relationship to SBI in febrile full-term newborns under 1 week of age seen in a PED. METHODS: A retrospective observational study was carried out on all children younger than 8 days of age with fever who presented to a single, tertiary care, PED from January 2009 to April 2014. Dehydration was defined as plasma sodium >150 mmol/L or >10% loss of birth weight. SBI was defined by the presence of a positive culture in the blood, urine, cerebrospinal fluid; osteoarticular infection; bacterial enteritis; or pneumonia. The primary analysis was the proportion of children with dehydration. A secondary analysis compared proportion of infection according to hydration status. RESULTS: Of the 895 children under 8 days of age who visited the PED, 69 consulted for fever. Seven patients were excluded because they were transferred from another hospital. Sixty-two eligible patients were included in the final analysis. Of these, 17 (27%) were dehydrated according to our definition. Only 2 patients had an SBI while 2 others had a final diagnosis of viral myocarditis and encephalitis, respectively. None of the 4 children with serious infection fulfilled our definition of dehydration, and all had a plasma sodium level lower than 145 mmol/L. CONCLUSIONS: Dehydration is frequently associated with fever in infants younger than 8 days of age seen in a PED. Early identification of dehydration may be useful in limiting the aggressive intervention in some of these infants.

Cuantificación de la inmunoglobulina G y la albúmina en el líquido cefalorraquídeomediante las modificaciones de las técnicas para otros fluidos biológicos / Immunoglobulin G and albumin quantification in the cerebrospinal fluid by m odifications in techni ques for other biological fluids

Objetivo:Evaluar los resultados de la estimación del estado funcional de la barrera sangre–líquido cefalorraquídeo (LCR)y la síntesis intratecal de inmunoglobulina G (IgG) por el sistema nervioso central mediante las modificaciones de las técnicas comerciales diseñadas para otros fluidos biológicos.Métodos:A muestras de LCR y suero de 61 pacientes se les realizaron electroforesis de disco en geles de poliacrilamida y cuantificación de proteínas totales (PT)en el Instituto de Neurología y Neurocirugía, Habana, Cuba (INN), entre los meses de abril y diciembre de 2014. Se determinaronlas concentraciones de albúmina e IgGempleando paralelamente técnicas comerciales modificadas en ellaboratorio y métodos validados para estos estudios. Se calculó el cociente albúmina (Qalb)y el índice IgG, como indicadores del estado funcional de labarrera sangre–LCR (BS-LCR)y de la síntesis intratecal (SIT), respectivamente.Resultados:Las PT y los patrones de electroforesis se correlacionaron con el Qalby albúmina, realizado por las técnicas modificadas. No se encontraron diferencias significativas entre las cuantificaciones de las técnicas validadas y modificadas para los valoresde albúmina en LCR (Z=0,41; p=0,6791), albúmina en suero (Z=0,08; p=0,9382), el Qalb (Z=0,21; p=0,8361), IgG en LCR (Z=1,65; p=0,0995) e índice IgG (Z=1,10; p=0,2721).Conclusiones:Se demuestra que estas modificaciones en técnicas comerciales diseñadas para otros fluidos bilógicos resultan útiles para estimar la funcionalidad de la BS–LCR y calcular la SIT de inmunoglobulinas. Las modificaciones introducidas a la técnica turbidimétrica y al UMELISA pueden ser estandarizadas para su validación en el diagnóstico de daño de la BS–LCR y de síntesis intratecal de IgG por el sistema nervioso(AU)

Objective:To evaluate the results of estimating the functional status of blood–cerebrospinal fluid barrier (B–CSFB) and intrathecal immunoglobulin synthesis (ITS)of IgG for central nervous systemby modifiedcommercial techniques designed for other biological fluids.Methods:Disc polyacrylamide gel electrophoresis and quantification of CSF total protein in CSF and serum of 61 patients were conductedat the Institute of Neurology and Neurosurgery (INN) between April and September 2014. The concentration of albumin and IgG was determined by commercial standardized techniques and by modifications of commercial techniques. Albumin ratio and IgG index were calculated and employed to evaluate B–CSFB permeability and ITS, respectively.Results:Total protein and protein electrophoresis patterns were correlated with the quantifications performed by modified commercial techniques. There was no significant difference between validated commercial techniques and modified techniques for quantifications of CSF albumin(Z=0,41; p=0,6791),serum albumin (Z=0,08; p=0,9382),Qalb (Z=0,21; p=0,8361), CSF IgG (Z=1,65; p=0,0995) andIgG index (Z=1,10; p=0,2721).Conclusions:The immunological studies in CSF obtained from modifying commercial techniques designed for other biological fluids are(AU)

Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension.

The object of this work was to explore if blood based biomarkers of brain damage could predict subclinical brain lesions and clinical outcome during follow-up in asymptomatic hypertensive patients. This was a cross-sectional study including 101 patients with essential hypertension and no clinical evidence of neurological disease and 53 healthy controls, followed by a longitudinal study of 62 hypertensive patients for an average of 33 months. Serum concentrations of two brain specific proteins (S100B and neuron specific enolase - NSE) were determined at inclusion. Fundoscopic exploration, brain MRI and echocardiographic studies were also performed. Clinical outcome at follow-up was registered: transient ischemic attack (TIA), stroke, vascular headache or migraine, cardiovascular events and death. Higher serum NSE and S100B concentrations were observed in hypertensive patients; and multiple regression analysis revealed independent associations of clinical variables and more severe white matter lesions only with NSE concentration. A panel combining two clinical variables (blood pressure>140/90 and years of hypertension>10) and serum NSE>13 µg/L predicted more severe white matter lesions with 80% sensitivity and 94.4% specificity. Higher NSE levels at inclusion were associated not only with the occurrence of vascular events related with the CNS (stroke, TIA and vascular headache), but also with an earlier presentation of these events during the follow-up period. Serum NSE concentration could be a useful biomarker to predict subclinical brain damage and future vascular events related with the CNS in hypertension. Blood based biomarkers could aid in filtering hypertensive patients with a higher risk of cerebrovascular disease for brain MRI scanning.

Association of status redox with demographic, clinical and imaging parameters in patients with Huntington's disease.

UNLABELLED: Huntington's disease (HD) is an autosomal dominant, progressive neurodegenerative disorder, caused by an expanded trinucleotide CAG sequence of the huntingtin (Htt) gene, which encodes a stretch of glutamines in the Htt protein. The mechanisms of neurodegeneration associated with the accumulation of Htt aggregates still remains unclear. OBJECTIVES: To determine oxidative stress biomarkers in HD patients and their relationship with clinical, demographic and neuroimaging parameters. DESIGN AND METHODS: Fourteen patients and 39 controls paired by age and sex participated in this study. Oxidative damage was assayed in blood by measuring malondialdehyde (MDA) and advanced oxidative protein products (AOPPs). Antioxidant status was determined by activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), reduced glutathione (GSH), protein thiols and total antioxidant capacity (FRAP). The Unified Huntington Disease Rating Scale (UHDRS) and neuroimaging studies were also employed. RESULTS: MDA, AOPP and GPx were significantly increased in HD patients with respect to the control group, while GR activity was decreased. FRAP correlated with age of disease onset, AOPP with motor severity (UHDRS score), age of patients and age of disease onset. Caudate atrophy was associated with lower plasma concentrations of GSH. CONCLUSIONS: These findings point to a redox imbalance in HD patients. GR activity could be a potential biomarker for symptom onset in asymptomatic gene carriers, while plasmatic GSH could be useful in monitoring the progression of neurodegeneration - as an expression of caudate atrophy - during the course of the disease.

Internet-based aftercare program for patients with bulimia nervosa in Mexico - A pilot study / Programa de seguimiento en línea para pacientes con trastornos de la conducta alimentaria en México - Estudio piloto

High rates of relapses are common in eating disorder patients after achieving the status of remission. The lack of support after completing a treatment can contribute to relapse. Therefore aftercare programs are needed to maintain the benefits of treatment, to reduce the risk of relapse, and to stabilize patients' well-being. This paper describes the Internet-based aftercare program ACTUA (Continued Support for Eating Disorders) developed to support patients with bulimia nervosa in Mexico. ACTUA is an adaptation of the program EDINA (Internet-based maintenance treatment for eating disorders) which was developed and evaluated in Hungary. In this paper we first describe the intervention which consists of different modules including a monitoring and feedback tool, forums, and counseling chat with a clinician. In the second part, we report on first experiences following the introduction of the program in two treatment centers in Mexico (Monterrey and Mexico City). Fifteen patients participated in a semi-structured interview assessing perceived benefits of participating in ACTUA as well as barriers that prevented patients from joining the program. Implications for the implementation of Internet-based interventions in Mexico are discussed.

Las elevadas tasas de recaída son comunes en los pacientes con trastornos de la conducta alimentaria una vez que se les ha dado de alta de un tratamiento. La falta de apoyo después de terminado el tratamiento puede contribuir a las recaídas. Por lo tanto, los programas de seguimiento son necesarios para mantener los beneficios obtenidos en el tratamiento, para reducir el riesgo de recaídas y para estabilizar el bienestar de los pacientes. Este trabajo describe el programa de seguimiento en línea ACTUA (Apoyo Continuo para Trastornos Alimentarios), desarrollado para dar apoyo a pacientes con bulimia nerviosa en México. ACTUA es una adaptación del programa EDINA (Programa de seguimiento en línea para trastornos alimentarios), que fue desarrollado y evaluado en Hungría. En este trabajo se describe primero la intervención, que consiste en diferentes módulos, incluyendo una herramienta de monitorización y retroalimentación, foro y un chat con un clínico para obtener supervisión. En la segunda parte se reportan las primeras experiencias después de la introducción del programa en 2 centros de tratamiento en México (Monterrey y Ciudad de México). Quince pacientes participaron en una entrevista semi-estructurada, que evaluó la percepción de los beneficios obtenidos de participar en ACTUA, así como las barreras que impidieron que los pacientes participaran en el programa. Se discuten las implicaciones que tiene en México la implementación de un programa en línea.

Breast cancer and body image as a prognostic factor of depression: a case study in México City / Cáncer de mama e imagen corporal como factor pronóstico de depresión. Un estudio de caso en ciudad de México

Introduction: Being diagnosed with breast cancer is devastating for women because they face a «sense of loss». Since this loss is observed by the women themselves as well as by those around them, this can often lead to depression. Objectives: (1) To verify a possible association between body image and depression; (2) To establish a relation between depression and time since breast cancer diagnosis. Method: The data came from the Beck Depression Inventory (BDI-II) and the Body Image Scale (BIS), which were used to evaluate the subjects. A random sample of n=120 women was divided into two groups. The women in Group 1 had been recently diagnosed with breast cancer, but had not at that time had any type of surgical treatment. The women in Group 2 had undergone a mastectomy over a year ago. Results: The women in Group 1 were found to be more severely depressed, and a statistically significant association was detected between depression and body image (p<0.05). In contrast, in Group 2, even though many of the subjects also felt depressed because of a distorted or disturbed body image, their depression was milder (p>0.05). Conclusions: The women in Group 1, the majority of whom were suffering from severe depression, had a disturbed body image even though they had not had a mastectomy. The women in Group 2, who had been operated, also suffered from similar (AU)

Introducción: El cáncer de mama constituye una patología de extremada prevalencia en la actualidad y con un alto impacto en la sociedad, tanto en los países desarrollados como en México, ésta patología ha aumentado en los últimos años. El diagnóstico es impactante para las mujeres porque se enfrentan al problema de «sentido de pérdida» y este hecho puede ser observado tanto por ellas como por otras personas, provocando con frecuencia alteraciones depresivas. Objetivos: Relacionar la imagen corporal y la depresión. En segundo lugar, determinar la posible implicación entre la depresión y el diagnóstico reciente y tardío. Material y métodos: Se recolectó información de datos a partir de la historia clínica, entrevista y aplicación del BDI-II (Escala de depresión de Beck) y el BIS (Body Image Scale) de 120 mujeres diagnosticadas y tratadas de cáncer de mama durante el periodo de Enero-Diciembre 2012. Se seleccionó la muestra aleatoria n=120 mujeres divididas en dos grupos. El grupo 1 con diagnóstico reciente sin intervención quirúrgica de la mama. El grupo 2 de mujeres mastectomizadas de más de 1 año. Resultados: El grupo 1 presentó mayor severidad de la depresión y se encontró una asociación estadísticamente significativa entre la depresión y la imagen corporal (p<0.05). Sin embargo, en el grupo 2 la severidad de la depresión fue menor, aunque la percepción de su imagen corporal también fue incompleta (p>0.05). Conclusiones: El grupo 1 presenta una percepción de la imagen corporal incompleta aunque no estén mastectomizadas y un mayor grado de depresión. Las mujeres del grupo 2 también se percibían su imagen corporal incompleta aunque presentaban menor grado de depresión (AU)